Efficacy of Hyperbaric Bupivacaine a nd Clonidine Combination Used as Unilateral Versus Bilateral Spinal Anesthesia During Unilateral Inguinal Hernia Surgery

Abstract

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The lump in the groin of patients with Inguinal hernias goes away with the application of slight pressure or by making the patient lie down. This study compared the efficacy of hyperbaric bupivacaine with clonidine in unilateral versus bilateral spinal anaesthesia during unilateral inguinal hernia surgery. The study was conducted in Chitwan Medical College from September 2019 to February 2020 including 50 patients aged 25-60, ASA grade of I -II and undertaking elective hernioplasty. Patients were randomized into the following groups: Group A received unilateral Inj. Bupivacaine 0.5% heavy 12.5mg + Inj. Clonidine 15mg in the sub-arachnoid block; Group B received bilateral Inj. Bupivacaine 0.5% heavy 12.5mg + Inj. Clonidine 15mg in the subarachnoid block. Variation in the motor block, duration of sensory, hemodynamic parameters, onset, and peak level were noted.  The mean ‘onset of sensory block’ in group A and group B was 1.52 minutes and 1.27 minutes, respectively. The ‘duration of sensory block’ was 237.1 minutes in group A and 218.4 minutes in group B. The ‘time to achieve peak’ was 8.32 minutes in group A and 8.12 minutes in group B. The ‘time to onset of motor block’ was 1.45 minutes and 1.72 minutes in group A and group B, respectively. However, ‘the duration of motor block’ was significantly higher in group A (210.5 minutes) than group B (198.1 minutes) (P< 0.05). A significantly higher mean arterial pressure was found in group A than group B (P< 0.05), which was recorded 1, 5, 15, 60, 90, and 120 minutes pre-operatively. Unilateral spinal anaesthesia achieves stable hemodynamics, adequate duration of the block for surgery, and rapid recovery compared to bilateral spinal anaesthesia.